{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T04:25:32Z","timestamp":1751430332383,"version":"3.41.0"},"reference-count":16,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["IJU Case Reports"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Docetaxel is a key treatment for castration\u2010resistant prostate cancer and is administered with prednisolone, which increases the risk of steroid\u2010induced diabetes. Its myelosuppressive effect also increases vulnerability to febrile neutropenia. Metformin is widely used for glycemic control; however, elderly cancer patients are particularly susceptible to metformin\u2010associated lactic acidosis, necessitating careful management of sick\u2010day and febrile neutropenia during chemotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Presentation<\/jats:title><jats:p>We report a 70\u2010year\u2010old male with castration\u2010resistant prostate cancer and diabetes mellitus who developed febrile neutropenia on Day 5 following docetaxel initiation. He progressed to shock with severe metabolic acidosis on Day 7 and died despite intensive care, including continuous renal replacement therapy. A retrospective review revealed continued metformin use despite prodromal fatigue and loss of appetite, likely due to impaired judgment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This case may have involved septic shock, but metformin likely worsened the lactic acidosis. It highlights the need for sick\u2010day education and monitoring in elderly cancer patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/iju5.70055","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T04:46:36Z","timestamp":1750135596000},"page":"411-414","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Metformin\u2010Associated Lactic Acidosis During Docetaxel Therapy for Castration\u2010Resistant Prostate Cancer: A Case Report"],"prefix":"10.1002","volume":"8","author":[{"given":"Y.","family":"Inoue","sequence":"first","affiliation":[{"name":"Department of Urology The New Tokyo Hospital  Chiba Japan"},{"name":"Department of Urology Tokyo Metropolitan Bokutoh Hospital  Tokyo 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